摘要
目的 探讨新诊断 2型糖尿病患者血脂谱和低密度脂蛋白 (LDL)亚组分的特征及与慢性并发症的关系。方法 采用横断面研究 ,调查 175例新诊断的 2型糖尿病患者 (糖尿病组 )和 39名无高血压、糖尿病和血脂异常的正常人 (正常对照组 )。分别测定两组的身高、体重、血压、腰围、腰臀比、血糖、血脂 ,并采用 2 %～ 16 %聚丙烯酰胺梯度凝胶电泳 (PAGE)法检测LDL颗粒直径。对糖尿病组患者进行眼底、尿微量白蛋白、尿肌酐和颈动脉、股动脉、髂总动脉内 中膜厚度 (IMT)检查。结果 糖尿病组总胆固醇 (TC)和三酰甘油 (TG)水平均明显高于正常对照组 [TC :(4 .5 9± 0 .80 )mmol/L∶(4 .32± 0 .5 4 )mmol/L ;TG :(1.91± 1.15 )mmol/L∶(0 .89± 0 .2 9)mmol/L ,P值均 <0 .0 5 ];LDL颗粒直径明显小于正常对照组 [(2 6 .5 9± 1.18)nm∶(2 7.4 3± 1.2 4 )nm ,P <0 .0 5 ]。相关和多元逐步回归分析显示 ,TG与LDL颗粒直径成负相关 ,且是LDL颗粒直径的主要影响因素。糖尿病组中 ,伴有大血管病变者的LDL颗粒直径明显小于不伴有大血管病变者。Logistic回归模型分析显示 ,LDL颗粒直径变小是糖尿病患者发生大血管病变的主要危险因素之一。结论 新诊断的 2型糖尿病患者普遍存在血脂紊乱 ,TG升高是LDL颗粒直径变小的主要影?
Objective To investigate the characteristics of lipid profile and low density lipoprotein(LDL) subfraction of newly diagnosed type 2 diabetes patients and their relationships with chronic complications. Methods To measure body height, weight, blood pressure, waist circumference, waist-to-hip ratio, blood glucose, lipid profile and LDL subfraction of 175 newly diagnosed type 2 diabetes patients and 39 normal individuals by cross-section study. 2%～16% polyacrylamide gradient gel electrophoresis was used for the measurement of the diameter of LDL particles. Eye fundus, urine microalbumin, urine creatinine and intima-media thickness(IMT) of carotid artery, femoral artery and common iliac artery were observed in diabetic group. Results Total cholesterol(TC) and triglyceride(TG) were significantly higher and the size of LDL particle was significantly smaller in the subjects of DM than those of N[TC:(4.59±0.80) mmol/L vs (4.32±0.54) mmol/L; TG:(1.91±1.15) mmol/L vs (0.89±0.29) mmol/L; LDL size: (26.59±1.18) nm vs (27.43±1.24) nm,P<0.05]. The size of LDL particle was negatively correlated with TG. Multiple stepwise regression analysis showed that TG was the major impact factor of the size of LDL particle. The size of LDL particle in patients with large vessel lesion was smaller than those without. Logistic regression analysis showed the size of LDL particle was one of the major risk factors of diabetic large vessel lesion. Conclusion Dyslipidemia is generally present in newly diagnosed type 2 diabetes. Elevated triglyceride is the major influential factor of the size of LDL particle in tern as the major risk factors of diabetic large vessel lesion.
出处
《上海医学》
CAS
CSCD
北大核心
2004年第7期452-456,共5页
Shanghai Medical Journal
基金
上海市卫生局医学发展基金重点研究资助项目 [2 0 0 1ZD0 0 2 ( 3 ) ]
关键词
2型糖尿病
血脂谱
低密度脂蛋白亚组分
并发症
Low density lipoprotein subfraction
Type 2 diabetes mellitus
Dyslipidemia
Complication
